Benefits of a subacute care unit in the rehabilitation of frail dependent older adults
Main Article Content
Abstract
Subacute Care Units are defined as an institutional resource with hospital beds where once a patient overcomes the acute phase of a disease, it is
possible for him to undergo a rehabilitation treatment with the objective of achieving functional recovery and reintegration into the community.
The purpose of this paper was to carry out a quasi-experimental before and after study where the subjects serve as their own controls, in order
to describe the baseline characteristics of the patients admitted to the subacute care unit with rehabilitation objectives, as well as their functional
gain after the intervention, measured as the difference between the Barthel index at discharge (final value) and admission to the EMU (baseline
value). For this, 122 people were included, obtaining as main results a positive functional gain of 40 points (p <0.001) and an efficiency parameter
(functional gain / days of hospitalization) of 1.18, considering the results obtained according to the literature as effective and efficient.
Downloads
Article Details
Section

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
References
World Population Ageing 2015 Report. Department of Economic and Social Affairs Population Di-vision. United Nations-New York, editor; 2015. [citado 2018 Sep 18]. Disponible en: https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Report.pdf
Omran AR. The Epidemiologic Transition: A Theory of the Epi-demiology of Population Change. Milbank Q. 2005; 83(4):731-57. DOI: https://doi.org/10.1111/j.1468-0009.2005.00398.x
Covinsky KE, Palmer RM, Fort-insky RH, et al. Loss of independen-ce in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. J Am Geriatr Soc. 2003; 51(4):451-8. DOI: https://doi.org/10.1046/j.1532-5415.2003.51152.x
Regazzoni C. La Argentina y el Envejecimiento Poblacional Con-notaciones estratégicas para la edu-cación, la economía y el desarrollo [Internet]. Centro Argentino de Estudios Internacionales. [citado 2018 Sep 17]. Disponible en: http://www.ciapat.org/biblioteca/pdf/958-La_Argentina_y_el_envejecimien-to_poblacional_connotaciones_es-trategicas_para_la_educacion,_la_economia_y_el_desarrollo.pdf
Censo Nacional de Población, Hogares y Viviendas 2010 Censo del Bicentenario Resultados de-finitivos, Serie B No 2 [Internet]. Instituto Nacional de Estadística y Censos (INDEC). [citado 2018 Sep 18]. Disponible en: https://www.indec.gob.ar/ftp/cuadros/poblacion/censo2010_tomo1.pdf
Informe HEDIS del Plan de Salud Año 2014 [Internet]. [citado 2018 Sep 17]. Disponible en: https://www1.hospitalitaliano.org.ar/multi-media/archivos/noticias_archivos/6/DOCUMENTOS/6_Informe_HE-DIS_2014.pdf
de Quirós F GB, Perman G, Lan-glois E, et al. La gestión del cuidado de los pacientes con enfermedades crónicas. ¿Hacia el rediseño de los sistemas de salud? Rev Hosp Ital B Aires. 2008; 28(1):5-11.
Abizanda Soler P, Soler PA, Ortiz ML, et al. La pérdida funcional al in-greso, principal variable explicativa de discapacidad y mortalidad al alta y al mes en ancianos hospitalizados. Revista Española de Geriatría y Gerontología. 2007; 42(4):201-11. DOI: https://doi.org/10.1016/S0211-139X(07)73552-7
Goodwin JS, Howrey B, Zhang DD, et al. Risk of continued institu-tionalization after hospitalization in older adults. J Gerontol A Biol Sci Med Sci. 2011; 66(12):1321-7. DOI: https://doi.org/10.1093/gerona/glr171
Jeong Y-G, Jeong Y-J, Kim W-C, et al. The mediating effect of caregi-ver burden on the caregivers’ quality of life. J Phys Therapy Sci. 2015; 27(5):1543-7. DOI: https://doi.org/10.1589/jpts.27.1543
Glasby J, Littlechild R, Pryce K. All dressed up but nowhere to go? Delayed hospital discharges and ol-der people. J Health Serv Res Policy. 2006; 11(1):52-8. DOI: https://doi.org/10.1258/135581906775094208
Wimo A, Rönnbäck E, Larsson B et al. “Misplacement” of elderly people in the caring organisation: re-asons and alternatives. Arch Gerontol Geriatr. 1999; 28(3):227-37. DOI: https://doi.org/10.1016/S0167-4943(99)00006-0
Rojas-García A, Turner S, Pizzo E, et al. Impact and experiences of delayed discharge: A mixed-studies systematic review. Health Expect. 2018;21(1): 41-56. DOI: https://doi.org/10.1111/hex.12619
Sabartés O, Sánchez D, Cervera AM. Unidades de subagudos. Revista Española de Geriatría y Gerontolo-gía. 2009; 44:34-8. DOI: https://doi.org/10.1016/j.regg.2009.01.008
Parker G, Bhakta P, Katbamna S, et al. Best place of care for older people after acute and during sub-acute illness: a systematic review. J Health Serv Res Policy. 2000; 5(3):176-89. DOI: https://doi.org/10.1177/135581960000500309
Andrews BC, Kaye J, Bowcutt M, et al. Redesigning geriatric health-care: how cross-functional teams and process improvement provide a competitive advantage. Health Mark Q. 2001; 19(2):33-48. DOI: https://doi.org/10.1300/J026v19n02_04
Morales-Martínez F. A Teaching Geriatric Hospital [Internet]. J Nutr Health Aging. 2019; 23: 4-8. DOI: https://doi.org/10.1007/s12603-018-1132-3
Morales-Martinez F. Geriatric medicine in Costa Rica [Internet]. Eur Geriatr Med. 2015; 6: 96-7. DOI: https://doi.org/10.1016/j.eurger.2014.06.016
Mahoney FI, Barthel DW. Functional Evaluation, the Barthel Index: A Simple Index of Indepen-dence Useful in Scoring Improve-ment in the Rehabilitation of the Chronically Ill. 1965. 5 p. DOI: https://doi.org/10.1037/t02366-000
Graf C. The Lawton Instrumental Activities of Daily Living Scale. Am J Nurs. 2008; 108:52-62. DOI: https://doi.org/10.1097/01.NAJ.0000314810.46029.74
Borowicz A, Zasadzka E, Gaczkowska A, et al. Assessing gait and balance impairment in elderly residents of nursing homes. J Phys Therapy Sci. 2016; 28(9):2486-90. DOI: https://doi.org/10.1589/jpts.28.2486
Patrick L, Knoefel F, Gaskowski P. Medical comorbidity and re-habilitation efficiency in geriatric inpatients. J Am Geriatr Soc. 2001; 49(11):1471-7. DOI: https://doi.org/10.1046/j.1532-5415.2001.4911239.x
Baztán JJ, González M, Morales C, et al. Variables asociadas a la recuperación funcional y la insti-tucionalización al alta en ancianos ingresados en una unidad geriátrica de media estancia. Rev Clin Esp. 2004;204: 574-82. DOI: https://doi.org/10.1157/13067367
Cortés JJB. Evaluación de fac-tores asociados a la actividad de una unidad geriátrica de mediana estan-cia y sus resultados sobre el estado de salud de los pacientes ancianos atendidos. Universidad Autónoma de Madrid. Facultad de Medicina ; 2005.
Stineman MG, Goin JE, Ha-milton BB, et al. Efficiency Pattern Analysis for Medical Rehabilitation [Internet]. Am J Med Qual. 1995; 10:190-8. DOI: https://doi.org/10.1177/0885713X9501000405
Ferrer RM, Carreres ÀA, Figuera RG. Evaluación de las características y la mejoría funcional de pacientes con accidente vascular cerebral y fractura de fémur en un programa de rehabilitación intensiva de un centro sociosanitario. Rev Esp Geriatr Ge-rontol. 2016; 51:303-4. DOI: https://doi.org/10.1016/j.regg.2016.01.009
Rousso SM. Managing financial pressures with subacute care. Healthc Financ Manage. 1995; 49(10):88-90, 92.28. Kothmann WL. Is subacute care feasible? Healthc Financ Manage. 1995; 49(10):60-3.